Association between neutrophil/lymphocyte ratio and disease severity in scleroderma patients

Fatemeh Nejatifar; Neda Mirbolouk; Irandokht Shenavar Masooleh; Ehsan Kazemnejad; Banafsheh Ghavidel-Parsa; Amir Mohammad Ghanbari; Habib Zayeni

doi:10.1016/j.heliyon.2023.e20576

Association between neutrophil/lymphocyte ratio and disease severity in scleroderma patients

Heliyon. 2023 Sep 30;9(10):e20576. doi: 10.1016/j.heliyon.2023.e20576. eCollection 2023 Oct.

Authors

Fatemeh Nejatifar¹, Neda Mirbolouk², Irandokht Shenavar Masooleh², Ehsan Kazemnejad³, Banafsheh Ghavidel-Parsa², Amir Mohammad Ghanbari⁴, Habib Zayeni²

Affiliations

¹ Hematology and Medical Oncology Department, Guilan University of Medical Sciences, Rasht, Iran.
² Guilan Rheumatology Research Center, Department of Rheumatology, Razi Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.
³ Guilan Trauma Research Center, Department of Biostatistics and Epidemiology, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran.
⁴ Student Research Committee, Faculty of Medicine, Guilan University of Medical Sciences, Rasht, Iran.

Abstract

Introduction: Systemic sclerosis is a chronic and progressive connective tissue disease with various manifestation. Inflammatory status is developed in early stages and is followed by major organs' dysfunction. Disease severity is evaluated mostly through Medsger scale. There is not any single laboratory test to evaluate disease severity, although some hematologic can reflect disease severity. In this study, we evaluated the association between hematologic indices (specially Neutrophil/Lymphocyte ratio) and Medsger score of disease severity.

Materials and methods: One hundred and twenty-three patients along with the same number of healthy controls were enrolled in this study. Demographic information and past medical records were gathered in first appointment. Hematologic indices were calculated based on the laboratory findings and the association between these indices and Medsger score of disease severity was evaluated.

Results: One hundred and twenty-three patients with mean disease duration of 9.54 and mean Medsger score of 7.42 were investigated in this study. Neutrophil count, erythrocyte sedimentation rate, red cell distribution width and NLR were significantly higher and mean platelets volume was significantly lower in SSc patients in comparison to controls. NLR was significantly correlated with pulmonary and cardiac involvements and Monocyte/Lymphocyte ratio was significantly correlated with the involvement of joint and tendons. We showed that NLR is a predictive factor for the severity of systemic sclerosis. We also found a cut off Value of 1.9 for NLR as a predictor for disease severity in our patients.

Conclusion: Our study shows that SSc and its severity is associated with some hematologic indices like NLR, MLR, platelets and hemoglobin. These indices can also specifically predict the involvement of some organs.